目的 观察小儿肺咳颗粒联合重组人干扰素α-2b雾化吸入治疗小儿毛细支气管炎的临床疗效。方法 选取2018年3月—2021年1月廊坊市人民医院收治的142例毛细支气管炎患儿，根据入院顺序将患儿分为对照组和治疗组，每组各71例。对照组患儿雾化吸入重组人干扰素α-2b注射液，100～150 kU/kg加入生理盐水3 mL，2次/d。治疗组在对照组的基础上口服小儿肺咳颗粒，1岁以下2 g/次，1～2岁3 g/次。两组患儿均治疗10 d。观察两组患儿临床疗效，比较治疗前后两组患儿临床症状改善时间，肺功能指标呼吸频率（RR）、潮气量（TV）和达峰时间比（TPTEF/TE），及炎症因子白细胞介素-6（IL-6）、C反应蛋白（CRP）、IL-4和转化生长因子-β（TGF-β）水平。结果 治疗后，与对照组的临床有效率78.87%相比，治疗组临床有效率（94.37%）明显高于对照组（P＜0.05）。治疗后，与对照组相比，治疗组喘息消失时间、咳嗽消失时间、肺部湿罗音消失时间、鸣音消失时间均明显短于对照组（P＜0.05）。治疗后，两组患儿RR较治疗前下降，TV和TPTEF/TE显著增加（P＜0.05），且治疗组TV、TPTEF/TE高于对照组，RR低于对照组（P＜0.05）。治疗后，两组患儿IL-6、CRP和IL-4水平较治疗前明显下降，而TGF-β明显升高（P＜0.05），且治疗组这些炎症因子水平明显好于对照组（P＜0.05）。结论 小儿肺咳颗粒联合重组人干扰素α-2b治疗小儿毛细支气管炎，可有效改善患儿临床症状，促进肺功能恢复。

Objective To observe the combination of Xiaoer Feike Granules combined with recombinant human interferon α-2b in treatment of children with bronchiolitis. Methods Children (142 cases) with bronchiolitis in the People's Hospital of Langfang from March 2018 to January 2021 were divided into control and treatment group based on visiting order, and each group had 71 cases. Children in the control group were atomization inhalation administered with Recombinant Human Interferon α-2b Injection, 100 — 150 kU/kg added into normal saline 3 mL, twice daily. Children in the treatment group were po administered with Xiaoer Feike Granules on the basis of the control group, 2 g/time for less than 1 year old children, 3 g/time for 1 — 2 years old children, twice daily. Children in two groups were treated for 10 d. After treatment, the clinical evaluation was evaluated, the improvement time of clinical symptoms, pulmonary function indexes RR, TV and TPTEF/TE, the levels of inflammatory factors IL-6, CRP, IL-4 and TGF-β in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (94.37%) was significantly higher than that of the control group (P < 0.05). After treatment, compared with the control group, the disappearance time of wheezing, cough, lung wet rale and ringing in the treatment group were significantly shorter (P < 0.05). After treatment, the RR in two groups were decreased, TV and TPTEF/TE were significantly increased (P < 0.05), and the TV and TPTEF/TE in the treatment group were higher than those in the control group, and the RR was lower than that in the control group (P < 0.05). After treatment, IL-6, CRP and IL-4 in the two groups were significantly decreased compared with those before treatment, while TGF-β was significantly decreased (P < 0.05), and the levels of these inflammatory factors in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Xiaoer Feike Granules combined with recombinant human interferon α-2b in treatment of children with bronchiolitis can effectively improve the clinical symptoms of children and promote the recovery of pulmonary function.

R974

河北省医学科学研究课题计划项目(20201305)